Anti Hypertensive Drugs
Hypertension is a high blood pressure.
Blood pressure is the force of blood pushing against the walls of arteries as it flows through them. Arteries are the blood vessels that carry oxygenated blood from the heart to the body's tissues.


Description
As blood flows through arteries it pushes against the inside of the artery walls. The more pressure the blood exerts on the artery walls, the higher the blood pressure will be. The size of small arteries also affects the blood pressure. When the muscular walls of arteries are relaxed, or dilated, the pressure of the blood flowing through them is lower than when the artery walls narrow, or constrict.

Blood pressure is highest when the heart beatsto push blood out into the arteries. When the heart relaxes to fill with blood again, the pressure is at its lowest point. Blood pressure when the heart beats is called systolic pressure. Blood pressure when the heart is at rest is called diastolic pressure. When blood pressure is measured, the systolic pressure is stated first and the diastolic pressure second. Blood pressure is measured in millimeters of mercury (mm Hg). For example, if a person's systolic pressure is 120 and diastolic pressure is 80, it is written as 120/80 mm Hg. The American Heart Association has long considered blood pressure less than 140 over 90 normal for adults. However, the National Heart, Lung, and Blood Institute in Bethesda, Maryland released new clinical guidelines for blood pressure in 2003, lowering the standard normal readings. A normal reading was lowered to less than 120 over less than 80.

Hypertension is a major health problem, especially because it has no symptoms. Many people have hypertension without knowing it. Hypertension is more common in men than women and in people over the age of 65 than in younger persons.

Hypertension is serious because people with the condition have a higher risk for heart disease and other medical problems than people with normal blood pressure. Serious complications can be avoided by getting regular blood pressure checks and treating hypertension as soon as it is diagnosed.

General treatment:
elevated blood pressures can be lowered  by 38% by making lifestyle changes and participating in the DASH diet, which encourages eating more fruit and vegetables.

Lifestyle changes that may reduce blood pressure by about 5 to 10 mm Hg include:reducing salt intake, reducing fat intake,  losing weight , getting regular exercise  ,quitting smoking , reducing alcohol consumption ,managing stress

Treatment:
By antihypertensive drugs

Antihypertensive drugs

Classes: Antihypertensive drugs classified into many classes depending on its mechanism of action to:

class 1: Cardioselective Beta-Blockers
 Beta-blockers lower blood pressure by (Blocking B1 Receptors in the heart ) to slow the heart rate and reduce the force of the heart's contraction .

Ex:

1- Atenolol :  Including:
  • Atelol (50,100mg) produced by PHARCO
  • Blokium (50,100mg) produced by MUP

2- Bisoprolol : Including:
  • Bisocard (5 mg) produced by GNP
  • Concor (2.5,5,10 mg) produced by Amoun

3-Metoprolol : Including:
  • Low press (100 mg) produced by Hipharm

Class 2: Non cardioselective beta blockers (Beta2 and alpha Blockers)
Beta 2 and alpha blockers combine the actions of alpha and beta blockers.Vasodilators act directly on arteries to relax their walls so blood can move more easily through them.

Ex:

Carvedilol:
  • Cardilolcs (25 mg) produced by Marcyl]
  • Carvid (6.25, 25 mg) produced by Kahira
  • Dilatrol (6.25, 25 mg) produced by Chemipharm

Class 3: Calcium channel blockers
Block the entry of calcium into muscle cells in artery walls. Muscle cells need calcium to constrict, so reducing their calcium keeps them more relaxed and lowers blood pressure.

Ex:

1-Amlodipine:
  • Alkapress (5 mg) produced by Alkan
  • Norvasc (5,10 mg) produced by Pfizer
  • vasonorm (5,10 mg) produced by Pharco

2-Deltiazem:
  • Altiazem (60 mg) produced by Eipico

3-Felodipine:
  • Plendil (2.5,5,10 mg) produced by AstraZeneca

4-Nimodipine:
  • Nimotop (10 mg) produced by Bayer   

5-Nifedipine:
  • Adalt (retard) (10,20mg) Produced by Bayer

Class 4: Angiotensin converting enzyme inhibitors (ACE inhibitors)
Block the production of substances that constrict blood vessels. They also help reduce the build-up of water and salt in the tissues. ACE inhibitors may be used together with diuretics.

Ex:

1-Captopril:
  • Capotril (25,50 mg) Produced by EIPICO

2-Enalapril:
  • Acapril (5 mg) produced by Acapi
  • Enalapril (5,20 mg) produced by October pharma

3-Lisinopril:
  • Lisinopril  (10 mg) produced by Sigma
  • Zestril  (5,10,20 mg) produced by Sedico

Class 5: Centrally acting antihypertensive
Centrally acting agonists act on the nervous system to relax arteries and slow the heart rate. They are usually used with other antihypertensive medicines.

Ex:

Methyldopa:
  • Adamat (250 mg) produced by ADWIK
  • Aldomet (250 mg) produced by Kahira

Class 6: Vasodilators antihypertensive
act directly on arteries to relax their walls so blood can move more easily through them. They lower blood pressure rapidly and are injected in hypertensive emergencies when patients have dangerously high blood pressure.

Ex:

Sodium Nitroprusside:
  • Na Nitroprusside (50 mg) Vial produced by Faulding
  • Niprid (60 mg) Ampoul   produced by SchwarzPharma


Class 7: Diuretics
help the kidneys eliminate excess salt and water from the body's tissues and the blood. This helps reduce the swelling caused by fluid buildup in the tissues. The reduction of fluid dilates the walls of arteries and lowers blood pressure. New guidelines released in 2003 suggest diuretics as the first drug of choice for most patients with high blood pressure and as part of any multi-drug combination.

Ex:

1-Atenolol+Chlorthalidone:
  • Blokium Diu (100mg+25mg) produced by MUP

2-Atenolol+Amiloride:
  • Teklo (100mg+5mg) produced by Acapi

3-Captopril+hydrochlorothiazide:
  • Capozide (50mg+25mg) produced by BMS

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